Objective:To investigate the changes in protein metabolism after the use of recombinant human growth hormone(rhGH) in gastrointestinal tumor patients after operation.Methods:Thirty-nine patients with gastrointestinal tumor were randomly(double-blind) divided into two groups: ①the control group(n=20),which was treated with hypocaloric parenteral nutrition and placebo,②the rhGH group(n=19),which was treated with hypocaloric parenteral nutrition and rhGH.The levels IGF-1 and protein metabolism were observed.Results:The concentrations of IGF-1,pre-albumin,transferrin and fibronectin were decreased in the two groups on the 3th day after operation.The administration of rhGH resulted to significant increase in serum levels of IGF-1,pre-albumin,transferrin and fibronectin.Conclusion:The administration of recombinant human growth hormone can increase the protein synthesis and improve the nutritional condition.

BACKGROUND:Cartilage tissue engineering scaffold is a substitution for extracellular matrix, and there is a great significance on the shape and pore structure of the scaffold.
OBJECTIVE:To retrospectively focus on the fabrication technology of three-dimensional porous cartilage tissue engineering scaffolds.
METHODS:The first author searched PubMed, ELSEVIER SCIENCEDIRECT, Wanfang and CNKI databases (2000/2013) to retrieve relevant articles about the fabrication technology tissue-engineered cartilage scaffolds. The key words were“cartilage tissue engineering;scaffolds;fabrication”in English and Chinese, respectively. RESULTS AND CONCLUSION:The fabrication technologies of three-dimensional porous cartilage tissue
engineering scaffolds are as fol ows:Phase separation/freeze-drying, hydrogels, rapid prototyping manufacturing, electrospinning, solvent casting/particulate leaching, gas foaming. The current cartilage studies have demonstrated that the pore size has a significance on the regeneration of the cartilage tissue, the pore size ranging from 100-250μm al ows for the regeneration of bone and cartilage tissue. The scaffold fabricated by the solvent casting/particulate leaching and gas foaming technology at a pore size of 100-250μm is suitable for the bone and cartilage tissue regeneration. To obtain the adequate biological and mechanical properties, researchers usual y combine a variety of methods to fabricate the cartilage tissue engineering scaffolds.

Objective: Compared with ketamine anesthesia, to investigate sevoflurane inhalation combining laryngeal mask airway for anesthesia induction in pediatric cardiac surgery.
Methods:A total of 40 pediatric patients with congenital heart diseases received elective cardiac surgery in our hospital from 2013-08 to 2014-01 were studied. The children were from 6 months to 2 years of age and randomly divided into 2 groups, n=20 in each group. Sevolfurane group, the children inhaled the mixture of 8%sevolfurane and 100%O2, laryngeal mask airway was used upon losing consciousness for mechanical ventilation, the anesthesia was maintained by (3-4)% sevolfurane inhalation to facilitate central venous catheter placement. Ketamine group, the children received intramuscular injection of ketamine (7 mg/kg)+atropine (0.01 mg/kg). The peripheral venous line was established upon losing consciousness, the intravenous midazolam (0.1 mg/kg), pipecuronium (0.10 mg/kg), fentanyl (5 μg/kg) were applied, then tracheal intubation was performed for mechanical ventilation and the anesthesia was maintained by (0.5-1)%sevolfurane to facilitate central venous catheter placement.
Results: Sevoflurane group had the shorter time for losing the consciousness than that in Ketamine group (48.90 ± 3.93) s vs (577.85 ± 116.41) s, P<0.05 and the shorter time for ifnishing the central venous catheter placement (11.15 ± 2.48) min vs (24.15 ± 4.02) min, P<0.05. The average blood pressure and heart rate were similar between 2 groups after laryngeal mask or tracheal intubation, P>0.05. The arterial PH value, PaCO2, BE and lactatein were similar between 2 groups, P>0.05.
Conclusion: Sevoflurane inhalation combining laryngeal mask airway could shortening anesthesia preparation time with simple management. It provided an important anesthesia option in pediatric cardiac surgery.

BACKGROUND:Hemiarthroplasty is a proven method for reconstruction of the hip joint function, especialy for the elderly patients who cannot tolerate the total hip arthroplasty. However, for the patients with osteoporosis, there are stil more controversial in clinical practice about using cemented or cementless femoral prosthesis for hemiarthroplasty. OBJECTIVE: To observe the repair effect of cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis. METHODS:The clinical data from 105 patients treated with hemiarthroplasty were retrospectively analyzed. Osteoporosis was diagnosed in these patients using the dual energy X-ray absorptiometry before surgery.Patients were divided into bone cement group (n=56) and cementless group (n=49) depending on different types of femoral stem prosthesis. The difference of efficacy between cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis was analyzed by comparing the operative time, volume of drainage, post-operative Harris scores of hip joint function and radiographic assessment (prosthesis subsidence, osteolysis, severe stress shielding, heterotopic ossification) during the folow-up after the replacement. RESULTS AND CONCLUSION:In the process of hemiarthroplasty in patients with osteoporosis, the operative time in the cement group was significantly longer than that in the cementless group (P < 0.05). However, there was no significant difference in the postoperative volume of drainage between these two groups (P > 0.05). At the 1, 3, 6 and 12 of folow-up after replacement, there were no significant differences in the Harris score of hip joint function, total effective rate and radiographic assessment between these two groups (P> 0.05). These results suggest that in the process of hemiarthroplasty in patients with osteoporosis, the clinical efficacy of cementless femoral prosthesis is similar to the cement femoral prosthesis, therefore two prostheses can al be selected; however, the operative time of the cement femoral prosthesis is longer than the cementless femoral prosthesis, so we can give priority to the cementless femoral prosthesis for patients with osteoporosis who can’t tolerate a long operative time because of the poor basic condition.

Objective: To analyze the prevalence and influencing factors of suicidal behaviors among middle school students in minority areas of Guizhou Province, and to provide the reference for targetedly preventing suicidal behavior among middle school students. Methods: Questionnaire survey including adolescent health information, Depression Self-rating Scale for Children(DSR-SC), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Pittsburgh Sleep Quality Index survey were conducted among 6 139 middle school students in minority areas of Guizhou Province, Logistic regression was used to analyze the influencing factors of suicidal behavior of middle school students. Results: A total of 1 241(20.2%) had suicidal ideation in the past 12 months, and 250 (4.1%) of middle school students had committed suicide in the past 12 months. Suicidal ideation among middle school students was positively associated with: female, non-residence, being only child, smoking, having poor relationship with teachers, poor relationship with classmates, school violence victimization, physical abused, sexual abuse, emotionally neglected, having depression, having sleeping disorders(OR=1.67, 1.64, 0.84, 0.72, 0.67, 0.58, 2.06, 2.45, 2.12, 1.68, 2.82, 1.62). While being women(OR=1.52), non-residence(OR=2.25), smoking(OR=0.52), poor relationship with teachers(OR=0.49), poor relationship with classmates(OR=0.47), school violence victimization (OR=1.79) and physically abused(OR=2.17), sexual abused(OR=1.97), physically neglected(OR=1.94), depressive symptoms(OR=3.14), sleep disorders (OR=1.66) were associated positively with the risk of suicide attempt. Conclusion Suicide-related behaviors are more common in minority areas of Guizhou Province. Teachers and parents should attach great importance to it, and their suicidal risk should be early recognized to reduce suicide-related behaviors.

Objective To study the efficacy of laparoscopic tumor resection combined with iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis. Methods There were 30 patients diagnosed as rectal carcinoma with synchronous hepatic metastasis detected by CT scan. Hepatic metastases were confirmed by needle biopsy under laparoscopy. Laparoscopic radical resection of rectal carcinoma and metastatic hepatic tumors was performed. Those metastatic tumors that could not be resected were managed by RAF. Iodine-125 was planted in the tumors' site. Results Seven new hepatic metastases were found by the laparoscopic ulstrasound during the operation. 8 hepatic metastatic lesions were removed, 25 tumors located in the right liver were managed by RAF. All patients were followed-up from 12 to 25 months(average 22. 3 months), Local recurrence was found in 6 patients, the 1-year survival rate was 73% (22/30). Conclusions Laparoscopic excision, Iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis is safe、effective、minimally invasive.

Objective:To study the optimal surgical timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis.Methods:A retrospective analysis of the clinical data of patients with acute cholecystitis who were treated at Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2016 to October 2020 with initial PTGBD followed by LC. These patients were divided into three groups according to the time intervals between LC with PTGBD. Patients who underwent LC 3~4 weeks after PTGBD were in the short interval group ( n=67); patients who underwent LC 5~8 weeks after PTGBD were in the intermediate interval group ( n=78); and patients who underwent LC>8 weeks after PTGBD were in the long interval group ( n=73). The baseline and perioperative data of the three groups were compared. Results:In 218 patients, 97 were males and 121 were females, aged (72.1±8.4) years. Before LC, the gallbladder wall in the short interval group (4.77±0.62) mm was significantly thicker than that in the intermediate interval group (3.85±0.34) mm and the long interval group (3.81±0.25) mm (all P<0.05). Intraoperative blood loss in the intermediate interval group was significantly less than that in the short interval group ( P<0.05). The operation time, conversion to laparotomy, placement of drainage tube, postoperative hospital stay and total hospitalization expenses in the intermediate interval group were significantly better than those in the other two groups (all P<0.05). The incidence of complications in the intermediate interval group was significantly lower than that in the short interval group [2.56% (2/78) vs. 14.93% (10/67)], and the long interval group [2.56% (2/78) vs. 12.33% (9/73), all P<0.05]. Conclusion:The best timing for sequential LC after PTGBD in acute cholecystitis was shown in this study to be 5 to 8 weeks after PTGBD.

Objective To explore the feasibility of automating the measurement of abduction angle after total hip arthroplasty(THA)on postoperative radiographs by using deep learning algorithms.Methods The data were retrospectively collected.A total of 381 cases were used to develop deep learning model.Two radiologists annotated the key points on the images(lateral-superior point and medial-inferior point of acetabular cups,tear drops).The data was split into training dataset(304 cases),tuning dataset(38 cases),and test dataset(39 cases).A 2D U-net model was trained to segment the key points and the abduction angle were automatically meas-ured.After development of the model,an external validation dataset was collected(143 cases).Dice similarity coefficient(DSC)and mean absolute error(MAE)were used to evaluate the prediction efficiency of the model in the test dataset and the external validation dataset.Bland-Altman test was used to analyze the agreement between the abduction angle measured automatically by the model and the physician measurement.Results The DSC were 0.870-0.905 and 0.690-0.750 in the test dataset and the external validation dataset,and the corresponding MAE were 0.311-0.561 and 0.951-1.310.For the result of Bland-Altman analysis,only 6.52％(3/46)and 2.08％(3/144)of the abduction angle measurements in the test dataset and external validation dataset were outside the 95％limit of agreement(LoA).In the qualitative evaluation of the abduc-tion angle,the agreement of the model with the physician were 97.8％and 90.3％in the test dataset and the external validation dataset.Conclusion It is feasible to use deep learning algorithms to automatically measure the abduction angle after THA on X-ray images,achieving similar accuracy to that of physician.

Objective To investigate the clinical value of indocyanine green (ICG) fluorescence navigation in laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) in elderly patients with acute cholecystitis. Methods A retrospective analysis was performed for the perioperative clinical data of the elderly patients with acute cholecystitis who underwent LC after PTGBD in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021 to February 2022. The 36 patients who underwent ICG fluorescence navigation were enrolled as experimental group, and the 26 patients who did not undergo ICG fluorescence navigation during the same period of time were enrolled as control group. Preoperative general information was analyzed for both groups, as well as time to identify the biliary system during surgery, time of operation, intraoperative blood loss, bile tract injury, conversion to laparotomy, time to first flatus after surgery, time to ambulation, time to removing abdominal drainage tube, time to return to normal diet, and length of postoperative hospital stay. The group t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the control group, the experimental group had a significantly shorter time to identify the biliary system during surgery (19.9±3.7 min vs 36.5±5.9 min, t =13.56, P < 0.05), a significantly shorter time of operation (50.6±8.5 min vs 80.9±10.6 min, t =12.48, P < 0.05), and a significantly lower amount of intraoperative blood loss ( χ 2 =6.91, P < 0.05). No patient was converted to laparotomy in the experimental group, while 2 patients in the control group were converted to laparotomy, and no bile duct injury was observed in either group. Compared with the control group, the experimental group had significantly shorter time to ambulation (10.2±2.4 hours vs 16.6±3.2 hours, t =8.92, P < 0.05), time to removing abdominal drainage tube (20.1±3.4 hours vs 30.7±4.7 hours, t =10.2, P < 0.05), time to return to normal diet (20.3±3.8 hours vs 31.2±6.0 hours, t =8.68, P < 0.05), and length of postoperative hospital stay [3.3 (3.0-4.3) days vs 5.3 (5.0-6.2) days, Z =5.91, P < 0.05]. Conclusion ICG fluorescence navigation can visualize the extrahepatic biliary system during LC after PTGBD in elderly patients with acute cholecystitis, which may help to achieve accurate operation, reduce the risk of surgery, shorten the time of operation, and accelerate postoperative recovery.

OBJECTIVETo explore the feasibility of transcatheter closure of atrial septal defect (ASD) under transthoracic echocardiography (TTE) guidance.

METHODSRetrospective analysis was performed in 65 patients with simple ASD who underwent transcatheter closure under echocardiography guidance in Fuwai hospital from February to August 2013. They were divided into TTE group (n = 30) and transesophageal echocardiography (TEE) group (n = 35). The TTE group patients who underwent localized anesthesia or basal anesthesia received transcatheter closure of ASD under the guidance of TTE. The TEE group patients who underwent tracheal intubation and general anesthesia received transcatheter closure of ASD under the guidance of TEE. The patients were followed up with TTE and electrocardiogram at one month after procedure at outpatient department.

RESULTSIn the TTE group, 28 occluders were implanted successfully and 2 patients were subsequently switched to TEE guidance because of unclear TTE images, and the occluder implantation in these 2 patients was successful. There were no obvious differences in age, sex, body weight, ASD size, and time of hospital stay between the two groups (all P > 0.05) . Compared with TEE group, the TTE group had a significantly shorter operation time ((52.77 ± 9.00 ) min vs. (60.11 ± 9.15) min, P < 0.05), respirator ventilation duration ((0.25 ± 0.95) h vs. (3.17 ± 0.69) h, P < 0.05), and stay time in ICU ((1.50 ± 1.96) h vs. (16.43 ± 6.99) h, P < 0.05). The dose of propofol required was significantly lower in the TTE group compared to TEE group ((2.41 ± 2.97) mg/kg vs. (9.43 ± 3.70) mg/kg, P < 0.05). The patients in both groups had no complications such as residual shunt, peripheral vascular injury or cardiac perforation at the time of hospitalization.No complications, such as occluder dislocation, residual shunt, or pericardial effusion were seen during follow-up at one month post procedure in both groups.

CONCLUSIONTranscatheter closure of ASD under TTE guidance is feasible and has a broad application prospects.

Body Weight ; Echocardiography ; Echocardiography, Transesophageal ; Electrocardiography ; Heart Injuries ; Heart Septal Defects, Atrial ; therapy ; Humans ; Length of Stay ; Pericardial Effusion ; Retrospective Studies